Hospital Costs for Nasopharyngeal Carcinoma

鼻咽癌醫療費用之研究

10.7078/TSMHMNJN.201012.0237

黃志銘(Chih-Ming Huang)；林慶宗(Ching-Tzung Lin)；呂宜興(Yi-Shing Leu)；邱世哲(Shih-Che Chiu)；邱亨嘉(Herng-Chia Chiu)

原住民 ； 醫療費用 ； 醫療不平等 ； 鼻咽癌 ； Aborigine ； healthcare costs ； nasopharyngeal cancer

安泰醫護雜誌

16卷4期（2010 / 12 / 01）

237 - 244

英文

台灣非都市人口之鼻咽癌(NPC)發生率與平均年齡正逐年上升，但探討鼻咽癌醫療對此族群造成之經濟負擔相關研究仍顯不足。若能更加了解影響鼻咽癌病人醫療費用之因素，將可幫助資源之有效運用。本研究之目的為探討台灣漢人及台灣原住民鼻咽癌病患之醫療總費用。本研究以1998年9月1日至2004年12月31日間於馬偕紀念醫院台東分院初診為鼻咽癌並接受治療之台灣漢人與台灣原住民病患為對象，共回顧42名患者之病歷及帳務紀錄。採用三個帳單周期之資料以評估包括門診次數、住院日數、醫療總費用等影響鼻咽癌醫療之變因。發現原住民病患確診後之醫療費用總數顯著較台灣籍病患為高。經過12個月之治療，鼻咽癌腫瘤分期偏高（T3及T4）之病患比起腫瘤分期偏低（T1及T2）之病患，更可能產生較高昂之醫療費用。針對門診使用量、住院天數及治療結果，兩組病患間未發現顯著差異。兩組病患皆能取得相似之醫療資源與藥物；然而於每個帳單周期原住民病患之費用均明顯較漢人病患高。綜上所論，由於漢人與原住民病患於門診使用量或住院天數未有不同，顯示兩組病患皆能得到相似之醫療資源。再者兩組病患之醫療結果亦未有不同。

Although both the incidence of nasopharyngeal carcinoma (NPC) and the average age of suburban Taiwanese are increasing, studies addressing the economic burden of NPC management in this population are lacking. Insight into factors that influence the cost of managing patients with NPC may result in more efficient use of resources. The purpose of this study was to determine the total medical expenditures for the management of NPC in Taiwanese and Taiwanese Aborigines. The charts and billing records of 42 Taiwanese or Taiwanese Aboriginal patients who were diagnosed with NPC and treated at the Taitung Mackay Memorial Hospital from September 1(superscript st) 1998 to December 31(superscript st) 2004 were reviewed. The influence of variables related to the management of NPC including number of outpatient clinic visits, length of hospitalization (days), and total medical charges was assessed during three different billing periods. Aboriginal patients had significantly higher total medical expenditures after diagnosis than did Taiwanese patients. Patients with larger tumor stages (T3 and T4) NPC were more likely to incur higher expenditures at 12 months as compared with patients at smaller tumor stages (T1 and T2). No significant differences in outpatient utilization, length of stay, or treatment outcome were found. Both groups had access to similar medical resources and treatment; however, aboriginal patients had significantly higher expenditures during any billing period than did Taiwanese patients. Taken together, there were no significant differences between Taiwanese and Aboriginal patients in terms of outpatient utilization or length of stay, suggesting that both groups had access to similar medical resources. Furthermore, there was no difference in treatment outcome between the two groups.